Understanding the Risks and Benefits of Amniocentesi

Did you know that the amniotic fluid your baby is floating in throughout the pregnancy is more than just a regular liquid? The amniotic fluid holds the answers to many doubts and concerns regarding fetal health, genetics, and congenital issues. The amniocentesis test can help doctors diagnose complications well before birth.

What is Amniocentesis?

Amniocentesis is a test performed during pregnancy to check for genetic abnormalities and other health complications in the fetus. This is an invasive test that involves taking a sample of the amniotic fluid with the guidance of an ultrasound.

The amniotic fluid surrounds the fetus in the placenta. The amniotic fluid not only protects the fetus from injuries but also provides essential nutrients, antibodies, and hormones from the mother to the baby throughout the pregnancy.

So, unless there is a need, doctors don’t touch the amniotic fluid until the time for delivery.

How is the Amniocentesis Test Performed?

This is an invasive test but does not require any hospitalisation.

• The doctor will have you lie on your back with your tummy exposed.
• They will clean a small area with an antiseptic solution and apply a gel to the surface for ultrasound.
• With the guidance of the ultrasound, the doctor will insert a thin needle through the belly, through the uterus to reach the amniotic fluid without touching the baby.
• A small amount of amniotic fluid is collected, and the needle is carefully removed.
• The fetal heart rate is monitored for a while to ensure the baby is safe and undisturbed.
• The entire procedure will take less than five minutes, after which you can clean up the gel and leave.

Need for Amniocentesis

The amniocentesis test will help check for the possibilities of genetic disorders like Spina bifida and Down syndrome. Your doctor or midwife may suggest taking the amniocentesis test if -

1. A routine pregnancy ultrasound can detect congenital conditions.
2. The screening tests during pregnancy show a high risk of chromosomal disorders.
3. You test positive for being a carrier of any genetic condition.
4. You have a family history of a genetic condition or a metabolic disorder.
5. Maternal age is over 35 years, thus increasing the risk of complications.
6. A high risk exists for Spina bifida – a condition where the spinal cord does not close fully before birth.
7. There is a risk of a genetic disease related to gender.
8. Complications in the third trimester can affect the baby.

When is Amniocentesis Performed?

The amniocentesis test is usually done between the 15th and 20th week of pregnancy. This will be the second trimester. In some cases, the amniocentesis test is performed in the third trimester. If there is a need to deliver the baby early or if there are chances of a preterm delivery, the amniocentesis test can be taken in the third trimester to determine if the fetal lungs are developed enough to breathe independently outside the womb.

It can also be used as a diagnostic tool to detect Rh incompatibility and UTIs in the mother. In both cases, necessary steps have to be taken immediately to reduce the risk and impact on the baby.

Risks of Amniocentesis

The amniocentesis test is an invasive test that involves inserting a needle. Like any medical procedure, this test also has a few risks, such as –

• Severe cramping – It is normal to experience some cramping during the test, but in some cases, it can be severe and last for a few hours after the test.
• Leaking of amniotic fluid – Insertion of the needle can puncture the amniotic sac, causing a leak from the injection site. As the injection is inserted through the vagina, into the uterus and amniotic sac, the leakage will be vaginal. In most cases, the leak will stop on its own within 48 hours with bed rest. In rare cases, the leak can continue, putting the baby and pregnancy at risk.
• Injury – This is a rare complication that can occur during the needle insertion, especially if the performing doctor is not skilled or experienced enough. Though the ultrasound is used to guide the needle carefully, in very rare cases, the needle can touch the baby, causing direct injury to the baby’s skin or organs.
• Infection – In very rare cases, bacteria can enter the amniotic sac during the procedure. Symptoms such as high fever, a rapid heart rate, and abdominal tenderness may indicate a possible infection. If left untreated, this can become very dangerous to both mother and baby, very quickly.
• Preterm labour – In the case of damage to the amniotic sac during the test, it can trigger preterm labour, but the chances are very low. When the test is performed later in pregnancy, it increases the risk of PPROM (preterm pre–labour rupture of Membranes). If the amniotic sac breaks during the procedure, it can lead to spontaneous labour much before the delivery date.
• Miscarriage – In general, the risk of a miscarriage is very low. However, if the test is performed before the 14th week of pregnancy, if there is more than one baby in the uterus, or if the mother has other health complications during the procedure, the chances of a miscarriage increase.

Book an online appointment with Dr. Neha Khandelwal for Pregnancy & Gynecology related issues.

Alternatives to Amniocentesis

Other alternatives to amniocentesis include NIPT (Non-Invasive Prenatal Testing), a blood test, and CVS (Chorionic Villus Sampling), which tests placental tissue.

These tests are taken only if the risk of certain conditions is high. The usual norm is to use multiple ultrasounds to detect and closely monitor potential complications.

Conclusion

Amniocentesis is not an easily prescribed test. Doctors don’t disturb the amniotic sac unless it is really necessary. When the test is performed by a well-experienced doctor in a well-equipped facility, the risks of complications are very low. If you are concerned about the complications, talk to your doctor in detail before going in for the test.

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